How to make type 2 diabetes easier to diagnose – Scott's Diabetes

[00:00:00] Scott K. Johnson: Welcome to BDI Briefs, another exciting installment where we briefly address important issues related to the emotional aspects of living and working with diabetes. Thank you for joining us today. I'm joined by Dr. Bill Polonsky, president of BDI. Behavioral Diabetes Institute and Director of Clinical Education Susan Guzman, Ph.D. Behavioral Diabetes InstituteThey are both world-renowned diabetes psychologists and two of the easiest people for me to talk to.

My name is Scott Johnson, I have had diabetes for over 40 years and have been active in the diabetes related social media space and industry for many years.

So with that introduction out of the way, Bill, what would you like to talk about today?

[00:00:53] Dr. Bill Polonsky: Thank you, Scott. I want to address a topic that doesn't get a lot of attention, and it has to do with what happens to patients when they are diagnosed with type 2 diabetes. It's the day they first find out they have type 2 diabetes. And what often goes unrecognized is that this is a very difficult moment for people. There are often very strong emotional reactions, and very strong negative emotional reactions. People fear what this means for their future, how other people will see them. The worry of disappointment and dejection that why is this happening when I thought I was doing all I could. This sense of mortality, is my life going to be shortened? So many strong emotional reactions that, if not really addressed, lead to people not engaging effectively with diabetes.

And then people are like, “I won't think about that,” and over time that can lead to some really bad consequences.

So as healthcare professionals, we know that it's a special moment when we sit down with a patient who finds out for the first time that they have type 2 diabetes, and how we talk to them about that can have a big impact.

The reason we are talking about this today is because while I was looking through the recent literature, a series of recent articles really struck me.

It's a small qualitative study by a colleague. I'll give you the first author's name here. I'm afraid I'll mispronounce it, but I think it's pronounced Boakye. It's spelled BOAKY E. She and her colleagues have actually published three fantastic papers that have been published in the last few years that have highlighted, first of all, how common is a very serious, worrying, negative emotional response to a type 2 diabetes diagnosis (Translation: https://pubmed.ncbi.nlm.nih.gov/36714250/).

It's also important to mention how these feelings are rarely addressed, talked about, or asked about by health care providers, and how common it is for people to feel abandoned by type 2 diabetes, not only scared and anxious about the future, but also not quite sure what they need to do next and feeling like no one is really there to support them.

She and her colleagues also highlight in these articles what patients want, what they need, how they want to be asked about how they feel when they find out they have diabetes, how they can get their questions answered and get better support. So I encourage you to read some of these articles, which have been published in Clinical Diabetes and Diabetes Spectrum in the last few years.

Ultimately, what these articles have told us is a reminder of what we have actually known for years: that there are very big problems and that we can do better. What should we do and how should we go about it? I am proud that my colleagues and I have been thinking about this problem for the past few decades.

In fact, a long time ago, in 2017, Published the first in a series of articles So we surveyed more than 3,500 people around the world, across 26 countries, and we asked all of them who have type 2 diabetes what happened when they received their diagnosis, both good and bad, and specifically what happened in their interactions with their healthcare professionals.

One of the things that we looked at was what happened in that moment that was really good for you, and it helped you feel comfortable living with type 2 diabetes over the next few years and actually being able to take on the challenges that come with type 2 diabetes and be comfortable and successful with it.

In our research, these two elements really stood out: I say, of course you will do it, but it's hard to do it often.

One is how well health care workers have been able to convey encouraging messages to newly diagnosed patients.

Letting people know that type 2 diabetes is not a death sentence. In the 21st century, if you have diabetes, you have a good chance of living a long and healthy life with the right care and effort. And giving people words of encouragement about what type 2 diabetes means and what to do. And doing it in a supportive way is important. That's the second point.

So don't just tell people, have the conversation. Ask people what they're worried about, what questions they have. To the extent we can, make sure people know that patients and their health care teams are in this together. We'll meet again soon. Let's see where we go next.

We try to put together a plan that you can implement. And at the end of the day, those two elements have had a huge impact in helping people be successful in the long term. Now, in the recent article by Boakye and her colleagues, and again, for any of you listening right now, and her colleagues, I apologize if I got their names wrong, they did a really great job in one of their last articles of bringing up a key theme about what we as healthcare providers need to do with our patients. Here's a quote from the first figure in their 2022 article. And this seems to follow on nicely from our own paper. And this is about the importance of not just telling people this, but running this as a conversation.

So I want to take a moment to talk about what's shown in this wonderful chart. I can't explain it better than my colleague, Dr. Guzman, could you explain a little bit, Susan, what's in this chart?

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